Active NPI
Patricia Matteson, LMSW
- Social Worker
- Syracuse, NY
National Provider Identifier
1295578045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 074369
- Practice address
- 301 Prospect Ave
Syracuse, NY 13203-1807 - Phone
- (315) 448-5111
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 074369 | NY | Primary |
Addresses
Primary practice location
301 Prospect Ave
Syracuse, NY 13203-1807
Mailing address
29 Grant St
Dexter, NY 13634-4071
Phone (315) 922-8239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1295578045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 GRANT ST",
"city": "DEXTER",
"state": "NY",
"postal_code": "136344071",
"telephone_number": "315-922-8239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 PROSPECT AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132031807",
"telephone_number": "315-448-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTESON",
"first_name": "PATRICIA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-18",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "074369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.